- Presence of thrombus (blood clot) in vein and inflammatory response in vessel wall- Virchow's triade- Can occlude artery causing ischemia- Can be dislodged, becoming thromboembolus that travels through vascular system until occluding flow in a small vascular bed

- Formation of fibrofatty lesions in large and medium vessels- Marked by cholesterol-lipid-calcium deposits- arteries become narrowed and reduce the flow of blood through the arteries.- Leading cause of coronary artery and cerebral vascular disease.

Risk factors associated with development of atherosclerosis that cannot be changed(Unmodifiable)(4)H. G. A. E

- Heredity- Gender- Age- Ethnicity

Risk factors associated with development of atherosclerosis that can be changed(Modifiable)(5)Cs. Hbp. Esl. Pi. O

- Flat, yellow, lipid-filled smooth muscle cells- enlarges by becoming thicker and slightly elevated.- Macrophages and smooth muscle cells become distended and form foam cells- immunologic and inflammatory changes result in progressive damage to the wall- can be reversible

Atherosclerosis pathogenesis:Fibrous atheromatous plaque(4)

- Lesions of advancing atherosclerosis- arterial wall changes initiated by chronic endothelial injury of many factors- lesion is gray/white, elevated and protrudes into lumen of artery- after endothelial injury, lipoproteins transport cholesterol and other lipids into arterial intima (innermost layer of the artery)

Atherosclerosis pathogenesis:Complicated lesion(4)

- Most dangerous- Plaque consists of lipids within area of dead tissue- Rigidity and hardening- may totally or partially occlude artery

- Depends on vessel involved and extent of vessel obstruction- Ischemia- Infarction: tissue that undergoes necrosis following cessation of blood supply- Necrosis: death of an area due to insufficient blood supply

Atherosclerosis: management(5)D. Dt. Sc. E. Dt

- Diagnostic- Diet Therapy- Smoking cessation- Exercise- Drug Therapy

Atherosclerosis: management:Diagnostic: Serum lipid tests

- Cholesterol is manufactured by liver but also present in many foods- used in synthesis of steroid hormones and to form bile salts- Transported by combining with proteins called lipoproteins

- Intermittent claudication (leg pain): severe cramp-like pain in affected extremity(ies), usually associated with activity- Skin may become pale, mottled and shiny in appearance- temperature of skin is cool to cold- Diminished to absent pulses in extremity- Pain, ischemia, impaired function, also may be infarction and tissue necrosis

- early stages often have none other than elevated BP- Often called a "silent killer"- symptoms secondary to effects on blood vessels or increased work of heart: fatigue, reduced activity tolerance, dizziness, palpitations, angina and dyspnea